Oral health

Key facts

Worldwide, 60–90% of school children and nearly 100% of adults have dental cavities.

Dental cavities can be prevented by maintaining a constant low level of fluoride in the oral cavity.

Severe periodontal (gum) disease, which may result in tooth loss, is found in 15–20% of middle-aged (35-44 years) adults.

Globally, about 30% of people aged 65–74 have no natural teeth.

Oral disease in children and adults is higher among poor and disadvantaged population groups.

Risk factors for oral diseases include an unhealthy diet, tobacco use, harmful alcohol use and poor oral hygiene, and social determinants.

Oral health is essential to general health and quality of life. It is a state of being free from mouth and facial pain, oral and throat cancer, oral infection and sores, periodontal (gum) disease, tooth decay, tooth loss, and other diseases and disorders that limit an individual’s capacity in biting, chewing, smiling, speaking, and psychosocial wellbeing.

Oral diseases and conditions

Dental cavities

Worldwide, 60–90% of school children and nearly 100% of adults have dental cavities, often leading to pain and discomfort.

Periodontal disease

Severe periodontal (gum) disease, which may result in tooth loss, is found in 15–20% of middle-aged (35-44 years) adults.

Tooth loss

Dental cavities and periodontal disease are major causes of tooth loss. Complete loss of natural teeth is widespread and particularly affects older people. Globally, about 30% of people aged 65–74 have no natural teeth.

Oral cancer

The incidence of oral cancer ranges from one to 10 cases per 100 000 people in most countries. The prevalence of oral cancer is relatively higher in men, in older people, and among people of low education and low income. Tobacco and alcohol are major causal factors.

Fungal, bacterial or viral infections in HIV

Almost half (40–50%) of people who are HIV-positive have oral fungal, bacterial or viral infections. These often occur early in the course of HIV infection.

Oro-dental trauma

Across the world, 16-40% of children in the age range 6 to12 years old are affected by dental trauma due to unsafe playgrounds, unsafe schools, road accidents, or violence.

Noma

Noma is a gangrenous lesion that affects young children living in extreme poverty primarily in Africa and Asia. Lesions are severe gingival disease followed by necrosis (premature death of cells in living tissue) of lips and chin. Many children affected by noma suffer from other infections such as measles and HIV. Without any treatment, about 90% of these children die.

Cleft lip and palate

Birth defects such as cleft lip and palate occur in about one per 500–700 of all births. This rate varies substantially across different ethnic groups and geographical areas.

Common causes

Risk factors for oral diseases include an unhealthy diet, tobacco use and harmful alcohol use. These are also risk factors for the four leading chronic diseases – cardiovascular diseases, cancer, chronic respiratory diseases and diabetes – and oral diseases are often linked to chronic disease. Poor oral hygiene is also a risk factor for oral disease.

The prevalence of oral disease varies by geographical region, and availability and accessibility of oral health services. Social determinants in oral health are also very strong. The prevalence of oral diseases is increasing in low- and middle-income countries, and in all countries, the oral disease burden is significantly higher among poor and disadvantaged population groups.

Prevention and treatment

The burden of oral diseases and other chronic diseases can be decreased simultaneously by addressing common risk factors. These include:

stopping tobacco use and decreasing alcohol consumption to reduce the risk of oral cancers, periodontal disease and tooth loss;

ensuring proper oral hygiene;

using protective sports and motor vehicle equipment to reduce the risk of facial injuries; and

safe physical environments.

Dental cavities can be prevented by maintaining a constant low level of fluoride in the oral cavity. Fluoride can be obtained from fluoridated drinking water, salt, milk and toothpaste, as well as from professionally-applied fluoride or mouth rinse. Long-term exposure to an optimal level of fluoride results in fewer dental cavities in both children and adults.

Most oral diseases and conditions require professional dental care, however, due to limited availability or inaccessibility, the use of oral health services is markedly low among older people, people living in rural areas, and people with low income and education. Oral health care coverage is low in low- and middle- income countries.

Traditional curative dental care is a significant economic burden for many high-income countries, where 5–10% of public health expenditure relates to oral health. In low- and middle-income countries, public oral health programmes are rare. The high cost of dental treatment can be avoided by effective prevention and health promotion measures.

WHO response

Public health solutions for oral diseases are most effective when they are integrated with those for other chronic diseases and with national public health programmes. The WHO Global Oral Health Programme aligns its work with the strategy of chronic disease prevention and health promotion. Emphasis is put on developing global policies in oral health promotion and oral disease prevention, including:

building oral health policies towards effective control of risks to oral health;

stimulating development and implementation of community-based projects for oral health promotion and prevention of oral diseases, with a focus on disadvantaged and poor population groups;

encouraging national health authorities to implement effective fluoride programmes for the prevention of dental caries;

advocacy for a common risk factor approach to simultaneously prevent oral and other chronic diseases; and

providing technical support to countries to strengthen their oral health systems and integrate oral health into public health.